Journal of Neurology Neurosurgery and Psychiatry 2005;76:454-455
© 2005 BMJ Publishing Group Ltd
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LETTERS
Possible transcallosal seizure induction by paired pulse transcranial magnetic stimulation in a patient with frontal lobe epilepsy
J Reis, F Rosenow, B Fritsch, S Knake, W H Oertel, H M Hamer
Interdisciplinary Epilepsy-Center, Department of Neurology, Philipps-University Marburg, Germany
Correspondence to:
Correspondence to:
J Reis
Interdisciplinary Epilepsy-Center, Department of Neurology, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35033 Marburg, Germany; reis@staff.uni-marburg.de
Keywords: epilepsy; focal cortical dysplasia; motor cortex; seizure; transcranial magnetic stimulation
The first 150 words of the full text of this article appear below.
Seizure induction by high frequency transcranial magnetic stimulation (TMS) has been reported in normal subjects and by single pulse TMS close to the epileptic focus in patients with epilepsy.1
Case report
We report an 18 year old patient with right frontal lobe epilepsy due to paramedian focal cortical dysplasia (FCD). The patient’s usual seizure semiology consisted of a somatosensory aura of the left hand followed by a tonic seizure of the left arm which evolved to a bilateral asymmetrical tonic seizure without loss of consciousness. In the two years preceding the study (see below) he had rare night-time seizures only. His antiepileptic medication consisted of levetiracetam 500 mg, phenobarbital 25 mg, and carbamazepine 1600 mg daily.
During presurgical videoelectroencephalogram (video-EEG) monitoring, interictal EEG showed right frontotemporal spikes. Ictal EEG revealed seizure patterns with a right frontal onset. Magnetic resonance imaging (MRI) showed FCD in the right superior frontal gyrus extending into the . . . [Full text of this article]
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Abstract
Electroconvulsive therapy (ECT) is the most effective and most rapidly acting treatment for severe treatment resistant major depression, but its use is limited by its cognitive side effects. Magnetic seizure therapy (MST) is a new form of convulsive therapy using high-dosage repetitive transcranial magnetic stimulation (rTMS) to induce focal cortical seizures under anesthesia. MST is under study as a means of reducing the side effects of ECT through the enhanced control over the sites of seizure initiation and topography of seizure propagation afforded by the relative focality of rTMS. This review traces the stages in the development of MST, from device development, to preclinical testing, to clinical trials. The results of a study on the comparative safety of chronic MST and electroconvulsive shock in non-human primates support the safety of both interventions, and indicate that the seizures induced by MST are more focal and have less impact on deeper brain structures. This non-human primate model and a controlled clinical trial in patients with major depression, suggest that MST may induce fewer side effects and less amnesia than ECT. Ongoing work will yield the first data on the antidepressant efficacy of MST. If ultimately shown to be effective, MST could represent a new, less invasive option for patients with severe treatment resistant depression or other disorders who would otherwise require ECT.
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Seizure incidence during single- and paired-pulse transcranial magnetic stimulation (TMS) in individuals with epilepsy .
Clinical Neurophysiology , Volume 115 , Issue 12 , Pages 2728 - 2737
L . Schrader , J . Stern , L . Koski , M . Nuwer , J . Engel, Jr.
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Abstract
Objective: We reviewed published data and our own data to determine a quantitative incidence of seizure in subjects with epilepsy undergoing single- and paired-pulse transcranial magnetic stimulation (spTMS and ppTMS) and to explore conditions that may increase this risk.
Copyright © 2003 Elsevier Inc. All rights reserved. Feedback | About Article Finder | Help
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Possible transcallosal seizure induction by paired pulse transcranial magnetic stimulation in a patient with frontal lobe epilepsy.
LETTERS
Journal of Neurology, Neurosurgery & Psychiatry. 76(3):454-455, March 2005.
Reis, J; Rosenow, F; Fritsch, B; Knake, S; Oertel, W H; Hamer, H M
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Seizure With Single-Pulse Transcranial Magnetic Stimulation in a 35-Year-Old Otherwise-Healthy Patient With Bipolar Disorder.
Case Report
Journal of ECT. 21(3):188-189, September 2005.
Tharayil, Biju Sunny MD; Gangadhar, B N MD; Thirthalli, Jagadisha MD; Anand, L MBBS
Abstract:
This case report describes a patient who developed a seizure with single-pulse transcranial magnetic stimulation during motor threshold estimation. The patient had no history of seizures in the past and no gross neurologic deficits. The only possible seizure-provoking factors were modest doses of lithium and chlorpromazine, which the patient was on, and family history of seizure in a brother. This report aims to highlight the fact that single-pulse transcranial magnetic stimulation may provoke a seizure even in the absence of gross neurologic abnormality.
(C) 2005 Lippincott Williams & Wilkins, Inc.
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Benign Epilepsy with Centro-temporal Spikes: Spike Triggered fMRI Shows Somato-sensory Cortex Activity
John S. Archer , Regula S. Briellman , David F. Abbott , Ari Syngeniotis , R. Mark Wellard , Graeme D. Jackson
Brain Research Institute, Neurosciences Building, Austin and Repatriation Medical Centre, Banksia Street,
Heidelberg West, 3081, Victoria Australia
Address correspondence and reprint requests to Graeme D. Jackson at Brain Research Institute, Neurosciences Building, Austin and Repatriation Medical Centre, Banksia Street, Heidelberg West, 3081, Victoria Australia. E-mail: BRI@brain.org.au
Copyright 2003 International League Against Epilepsy
KEYWORDS
Benign epilepsy with centro-temporal spikes • BECTS • Rolandic epilepsy • Functional MRI • fMRI • Spike triggerd fMRI
Summary:
Objective: We performed spike triggered functional MRI (fMRI) in a 12 year old girl with Benign Epilepsy with Centro-temporal Spikes (BECTS) and left-sided spikes. Our aim was to demonstrate the cerebral origin of her interictal spikes.
Methods: EEG was recorded within the 3 Tesla MRI. Whole brain fMRI images were acquired, beginning 2–3 seconds after spikes. Baseline fMRI images were acquired when there were no spikes for 20 seconds. Image sets were compared with the Student's t-test.
Results: Ten spike and 20 baseline brain volumes were analysed. Focal activiation was seen in the inferior left sensorimotor cortex near the face area. The anterior cingulate was more active during baseline than spikes.
Conclusions: Left sided epileptiform activity in this patient with BECTS is associated with fMRI activation in the left face region of the somatosensory cortex, which would be consistent with the facial sensorimotor involvement in BECT seizures. The presence of BOLD signal change in other regions raises the possibility that the scalp recorded field of this patient with BECTs may reflect electrical change in more than one brain region.
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Accepted August 25, 2002.
DIGITAL OBJECT IDENTIFIER (DOI)
10.1046/j.1528-1157.2003.02502.x About DOI
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